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Lumbar Degenerative Disc Disease
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Lumbar radiculopathy/sciatica is term used to describe radiating leg pain, tingling, numbness, or weakness caused by inflammation or compression of a spinal nerve in the lower back. Lumbar radiculopathy can result from a Degenerated disc,herniated disc, Spondylolisthesis or spinal canal stenosis (narrowing of the lumbar spine).
Herniated Disc
- Tear in the outer wall (annulus) of the disc allows the inner gel (nucleus) to protrude into the spinal canal
Natural History (“Doing Nothing”)
- Not all degenerated discs are symptomatic
- Symptoms may resolve with rest and conservative treatment of 2-3 weeks.
- Herniated material may get shrink over time.
“Cauda Equina Syndrome”
- Emergency
- Loss of bowel and bladder function, weakness or perianal numbness due to pressure an all of the nerves running through the spinal canal
- Caused by large herniated disc
- Surgical treatment needed urgently
Three Phases of Treatment for Lumbar Disc Herniation:
- Phase I – Non-Invasive Treatments
- Phase II – Interventional Pain management/ Spine injections
- Phase III – Surgery (Endoscopy/MIS)
- Goals of Each Phase:
- Relieve Pain
- Improve Function
Treatment Options for Lumbar Disc Herniation: Phase I
- Rest
- Oral Medications
- Steroids
- Non-Steroid Anti-Inflammatories (NSAIDs)
- Physical Therapy and Home Exercise
- Ice and Heat
Treatment Options for Lumbar Disc Herniation: Phase II
- Epidural Steroid Injections
- Day care procedure
- Done with x-ray guidance
Treatment Options for Lumbar Disc Herniation: Phase III – Surgery